The prognostic value of initial EDI scores in anorexia nervosa patients: a prospective follow-up study of 5--10 years. Eating Disorder Inventory

Abstract

Aim: To study in a prospective manner the long-term prognostic value of the initially recorded Eating Disorder Inventory (EDI) scores in anorexia nervosa (AN) patients.

Methods: The 5--10-year outcome of 26 consecutive malnourished AN patients was prospectively recorded according to the initial EDI score. We selected only patients with full 6-month assessments for more than 5 years (mean 8.5 years). Eating behavior, quality of life, autonomy and insight capacity were prospectively assessed by the Morgan-Russell scale and a semi-structured interview. At the end of follow-up, 13 patients recovered and the 13 others had a poor outcome.

Results: In monovariate analyses, high initial EDI total score (P <.0007) and high initial scores for perfectionism (P <.001), ineffectiveness (P <.002), interpersonal distrust (P <.004), interoceptive awareness (P <.03) and drive for thinness (P <.05) were significantly associated with a poor prognosis 5--10 years afterward. In a multivariate analysis, only high initial scores for perfectionism (F = 8.43; P = 0.008) and interpersonal distrust (F = 7.46; P = 0.012) were significantly associated with illness severity.

Discussion: High EDI total score and subscales for perfectionism and interpersonal distrust could predict a long-term severe outcome in AN.